A day after House vote, Trumpcare fears rising
The backlash to the Republican-backed plan to repeal and replace the Affordable Care Act was swift and damning by mid-afternoon Thursday.
Narrowly passing the U.S. House of Representatives, the American Health Care Act was approved Thursday by a 217-213 margin, which saw the Democrats vote “no” in a block and an additional 20 members of the GOP opposing the measure.
U.S. Rep. Patrick Meehan, R-7 of Chadds Ford, was one of the few who broke from party lines to try to halt a bill he said “doesn’t keep the promises I made to my constituents.”
“It threatens people with pre-existing conditions with skyrocketing costs,” Meehan said. “It threatens essential health care coverage like mental health and opioid addiction treatments. Monthly premiums for many, particularly older Americans nearing retirement, will rise.”
President Donald Trump and House Speaker Paul Ryan suffered a stunning defeat in late March when the GOP-controlled House was unable to come up with the votes necessary to pass the bill. Pulled before the vote took place, Meehan said afterwards that he would have voted against it for similar reasons he gave Thursday.
The Republican bill passed on Thursday will allow states to opt out of Obamacare provisions that prevented insurers from imposing greater costs to those with pre-existing conditions and it had required insurers to cover 10 essential health benefits such as maternity care and prescription drugs.
Both Meehan and U.S. Rep. Ryan Costello, R-6, of West Goshen, had voted in favor of the initial AHCA bill in earlier committee votes. Costello joined Meehan and the 19 Republicans who voted against it Thursday.
States are now able to set up high-risk insurance pools where insurance companies have the potential to hike up premiums to an unaffordable level.
Most troubling is that pre-existing conditions have no set parameters, with some insurers considering pre-existing conditions to be acne, anxiety, asthma, depression, sleep apnea, transsexualism and many others. Those conditions facilitate higher insurance premiums, or are grounds for the state placing those individuals into high-risk pools. It remains unclear how quickly insurance premiums could rise.
In March, it was the far-right Republicans in the House Freedom Caucus that created the road block in the March vote, but this week they gave credit to the “hard work of conservatives in the House” in which the bill now “allows states the ability to undo the most costly aspects of Obamacare that are hurting American families,” the caucus released in a statement.
The Pennsylvania Association of Staff Nurses and Allied Professionals released a statement on Friday regarding the Republican health care vote. “Patients will die if we allow this plan to take effect,” said PASNAP President Patty Eakin. “The uninsured and underinsured, and those who struggle to afford high deductibles and out of pocket costs, will delay vital care.”
Eakin warned that patients will only come to the emergency room when their symptoms are unbearable, “when it may be too late for us to help.”
“This plan hurts our most vulnerable patients — kids, the elderly, people with disabilities and chronic illnesses — to fund tax giveaways for the rich,” the statement continued. “It is cruel.”
Meehan said in March that the “status quo” of Obamacare would “fall apart” if untended. His priorities were to keep certain provisions such as protections for those with pre-existing conditions and coverage for children up to the age of 26 and support of Medicare.
The goal of he and many Republicans was to adjust the fee-for-service (FFS) model that the ACA was built upon, which critics say is the reason for exponential health care costs. In the FFS model, payers reimburse for all services, regardless of their impact on patient health, which has been described as a “quantity over quality.”
Meehan said the intent was to move to more accountable care so that there is a payment for individuals whose care is managed, as preventative care is less expensive.
“(It’s to) create a kind of market in which providers would offer coverage for the whole individual and get a large enough market that they can shift risk,” Meehan said in March, adding that savings realized through this could be placed back into the market to accommodate the 5 percent of people who utilize 55 percent of the services.
However, the protections for individuals with pre-existing conditions seem to have been lost in translation.
“Essential health benefits and pre-existing conditions protections were my benchmarks,” Costello said. “I didn’t feel that this legislation satisfied those benchmarks.”
Once the ACA replacement passed through the House on Thursday, Meehan was quick to express his discontent.
“This bill doesn’t repeal or fix Obamacare,” Meehan said. “It simply shifts its failures from one group of Americans to another.”